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Author
Topic: PEP after high risk (Read 33581 times)

I had unprotected anal sex Saturday morning (clever eh) with a guy I'd only just met, he told me he was neg and likewise I assured him the same. Today he called me to say he had just been told he was Positive. I panicked slightly (although to be fair I've been panicking all weekend )

Got myself down to my local GUM clinic and they have given me PEP. I'm not a betting man but I would think the odds aren't in my favour, from what he said he seroconverted recently so VL must be high and it was around 60 hours from incident to me taking my first PEP tablet.

Well, I guess i just wanted somewhere to share this with, feeling very stupid and lonely at the moment. Been reading the site and thankful to all the info you provide. Here's to a long wait

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I was bottom But yeah I'm doing the only pro-active thing I can do now i guess (apart from using condoms on the day... but im really trying hard to not beat myself up over this)

update

Anyway I'm taking truvada and kaletra ... 2 and half hours later and just thrown up, feel very sick - this isn't going to be nice

Sadly, it is unlikely to be nice. HIV meds remain some of the strongest prescription medications available. When I was on Kaletra, the nausea was overwhelming. You must remember to eat with the meds, and avail yourself of all the tricks in our LESSONS section on Keletra and it's side effects to counteract the nausea. Some are over the counter/nutritional, some are prescription. some, depending on where you live, are legal, some not.

If you are fortunate, you will only have to endure this for a month. You really do have my sympathies regarding the side effects. My current combination involves Norvir as well (one of the components of Kaletra) and it quite literally kicks my ass.

Logged

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

You may already know this, but just in case, your countdown for testing for a conclusive result is 13 weeks from your completion of PEP. You can do an initial test at 6 weeks after completing the regimen. If you test negative at 6 weeks, the likelihood is that you will continue to test negative.

Good luck and fir future reference learn from this incident, Have all the anal sex that you want to. Justdo it the safer way and make sure the insertive partner is always wearing a condom, No exceptions,

I kinda figured you were on Kaletra and Truvada - it's currently the PEP combo of choice here in the UK. A mate of mine did the same PEP combo at the end of the summer and he had the nausea issue the first few times he took it, but then it settled down and he had no further problems for the rest of the month. He tested negative, btw, even though he also started PEP late - way later than you.

Hang in there and keep taking those pills, no matter how horrible they make you feel. And don't beat yourself up. What's the point? You're human like the rest of us, and human beings make mistakes.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Thanks for all your comments. I spent around 4 hours last night with D and V and shivering cold.. was dreading taking them today but took some antiematics which seem to have worked.

Read up on all the lessons which give some really good advice, at least i'm prepared for what's going to happen down the line.

Also, specific med question here ... Do i need to take the truvada with the kaletra? At the moment I'm taking 2 keletra in morning and night, and i took my truvada at midday, I was only told I had to keep the timings the same so should I stick with doing this from now on in?

It would make more sense to take the Truvada at the same time as one of your Kaletra doses for the simple fact that you would be less likely to forget the Truvada. Other than that, it shouldn't really matter. There's one bloke here who spaces his meds out throughout the day and he seems to be doing fine. I couldn't do it, I have enough trouble taking meds once a day.

There's quite a bit of winter vomiting virus going around - it could be that and your gastro issues are just coincidental with starting the meds. If it continues or is very severe, please get in touch with your GUM. WVV usually only lasts 24-48 hours.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Good idea, i'll add the truvada onto my morning kaletra dose, it will only be moving it 2 hours which hopefully wont mess with the timings, but am thinking this is becoming slightly futile seeing as the guy texted me today to say he had the flu end of december, which he thinks was his seroconversion, hence his VL is likely to be high :/

I saw the PEP specialist yesterday, was good to talk to someone about this, I'm not as convinced as he is that this will work (he says with the new drugs, studies are showing 98% success on PEP) but the fact that the guy recently seroconverted and talking through it with the specialist I actually had two exposures that night (wont go into graphic details lol) and the lateness in taking pep etc, one "good" thing is that the guy who seroconverted is going to the same clinic so they will be able to do resistance testing.

Anyway, I'm banned from going onto google over this from him lol, but I am preparing for the the diagnosis I expect to get. I'm learning that HIV isn't death, it's a manageable chronic infection, sure its not nice, and I'll be delighted if I somehow escape it, but the reality is I'm going to be OK no matter what is said in a few months time. I'm trying to turn my feelings of anger/stupidness/regret around... I only hope that when I'm told, then sometime down the line I can wake up without thinking "HIV" as my first thought, which is all that's happening now. Anyway, I'm at risk of abusing this forum, guess I just needed somewhere to talk my experience through so I thank you for being there for that.

KH, I am sure your intentions are the best. However, if you had read the opening thread in this forum you would know that members are supposed to write only in their own threads and not those of other members.

■Only those Moderators and members who are authorized to answer questions in the Am I Infected? forum are permitted do so. Unauthorized responses may be deleted without permission of the poster. Repeatedly posting replies of this nature may result in a Time Out or permanent ban, at the discretion of the Moderator Team.

Due to the nature of my incident and timings I'm not expecting PEP to be effective in my case, my question is will PEP have any effect on HIV progression? I can't find any studies that followed people that took PEP and then seroconverted, but would taking pep do anything other than delay seroconversion? I'm thinking specifically about things like drug resistance, and how it effects the immune system. I guess at the moment, if HIV has taken hold then the PEP is keeping it in check, once I've stopped then things will continue as if I hadn't taken it and I wont suffer any detrimental effects for having taken PEP. Also, on a personal front, do the feelings of anger/guilt/regret ever go away? - please tell me this gets easier with time.

HIV isn't easy to transmit. Being the bottom during unprotected anal sex with an HIV positive partner is the riskiest of the sexual modes of transmission but you having been infected even without the PEP is not a certainty.

In fact, all things being equal, the data suggests that from a one off episode of unprotected anal you're likely to have dodged the bullet.

As others have noted, you just have to wait for the test results. I know it's difficult to do anything other than speculate but perhaps chasing studies and worrying about resistance is not helping you cope with this.

Those are matters that can be dealt with later. Burn that bridge when you jump off it, so to speak.

As for the guilt and regret, well yes those feelings do abate with time for most people.

Well, I finish PEP on Monday, first two weeks was mentally very hard as im sure you can tell from posts, but last two weeks I've took your advice and concentrated on other aspects of my life, so no sitting on here for ages (although this site is great for info in the lessions sections)

Sadly, my STD check came back with Gonorrhea - so i'm fairly resigned as to what is going to happen.. I'm going to test in 6 weeks from Monday, it's good to know there is somewhere I can come to when I do get the results.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Yup, i appreciate nothing is certain, but I have been told that him having gonherrea massively increases the risk of him passing Hiv to me... isn't it amazing that one drunken mistake can change my life forever.

Tomorrow morning is my last dose of PEP, funnily enough I was so wanting this to end at the start of the treatment, now I want to keep on taking them forever if it delays it!

This will be my last post now till my results, thanks for your help on this site, also the pep specialist nurse at the local HIV outpatients clinic has been amazing, and I'm getting some counselling through THT shortly. All of these things should help with the wait and of course gives an insight into the care available for me. Right, talk to you all in six weeks

Quick question, firstly I tested negative on a 4th gen quick test 2 weeks post pep ... Next Monday will be 4 weeks after finishing pep, before the weekend I developed enlarged lymph nodes on my neck (confirmed by GP today)... I know symptoms mean nothing on this part of the site, but I was wondering if someone could advise on the following

If i'm experiencing swollen lymph nodes as part of seroconversion, will a 4th gen test on Monday show positive? (i'm thinking that seroconversion is the body producing antibodies so a week or so after symptoms develop then a test will show positive?)

I know that the enlarged lymph nodes could be an unhelpful coincidence, and that many many things cause them, but I also have to be realistic, realise I had a high risk, and get myself into the system as quick as possible (my local clinic participated in the SPARTAC study and HAART will be available from day 1 no matter what my counts are if I so wish) - so , do the experts think if I test next week, and if my enlarged lymph nodes are due to a seroconversion, would you expect the test to show positive?

Swollem lymph nodes happen for all sorts of reasons that have nothing to do with HIV. It is very unlikely you would be experiencing ARS at this point.

If you can be a little more patient and wait to test at 6 weeks after completing PEP, then a negative at that point would be much more meaningful. A negative at 6 weeks post-PEP would strongly point the way to continuing to test negative.

In the meantime you need to keep your hands off of your swollen lymph nodes. They are very sensitive to the touch and fingering them can create a bigger problem than you might have otherwise.

Thanks Andy... Trust me I'm not going anywhere near those lymph nodes - I want them to go down!!! It's so tight around my throat, but then if this is all I get during seroconversion then I should count myself lucky.

Rang the HIV clinic yesterday just to tell them about the lymph nodes and they got me in straight away, was examined by two doctors - lymph nodes in neck well up, but no other swollen lymph nodes anywhere else

Well, they are doing a 4th gen assay, they put it through urgently and I was promised i'd be told today but not heard and clinic now closed, so I guess tomorrow i'll know more - they said it's more sensitive than a quick test in my scenerio.

I'll know a bit more tomorrow, if this is primary infection they say that the tests should pick up the p24 antigen, though they also said that lack of fever/rash is a good thing... I have a strong feeling that the result will be positive tomorrow (and if i'm lucky I will be following the advice of 6 and 12 week post pep testing, but somehow I don't think i'll be lucky enough to hear any more negative results)

Negative. I rang the clinic around midday in complete panic mode to be told "didn't you get the text we sent yesterday".. Actually feel sick just with the state i'd got myself into.

Anyway, I'm hoping that means my lymph nodes swollen isn't anything to do with a seroconversion.. Am I right in thinking that if I was seroconverting then the 4th gen duo test would likely pick up the p24 antigen?

I've now developed a fever ... Just over a week that lymph nodes came up - so fed up with all of this, if this is seroconversion I just want it to come and go not last this long. Lymph nodes in neck up so much too, I'm not poking them but finding it difficult to even move neck

well I'm not testing till another 2 weeks, which will be 6 weeks post pep ... All the stress of testing is just too much - I'm probably at that point where not enough p24 or antibodies are there to show up so there's not much to do.

The seasons are changing again and seasonal change always brings with it various bugs. There's every chance that this is all you're dealing with. I know several people here on the IOM who are currently ill with precisely what you describe - and no, they have not been at risk for hiv infection in recent weeks. They just have a spring bug.

Carry on with your testing at the appropriate time. I'm still expecting you to test negative.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I don't actually think i've got a fever, im getting chills and hot flushes on and off though, but just bought a digital thermometer and temp was 36.5 - i'm not burning up or anything.

So yesterday in the middle of my panic I looked in mirror and found a rash convering the front and side of my chest/stomach, it lasted around an hour then went - I know, like Ann said, that this is the time of year for bugs etc but I never get ill, and to have all this happen almost 4 weeks after stopping PEP, well - lets just say i'm scared. I also got a mouth ulcer yesterday, which cleared up by this afternoon.

I'll get in contact with the HIV clinic tomorrow, to tell them about the rash/chills/mouth ulcer to see waht they say - Thing is I don't want to keep testing too early to pick it up as it's just increasing my anxiety levels to becoming unbearable. Unless they suggest otherwise I'll stick to the advice here and test in another two weeks, then if this is seroconversion antibodies will surely be showing at that stage.

I'm never ill, then after stopping pep, within the timeline expected for seroconversion I get Lymph nodes, chills, a rash that lasted an hour, mouth ulcer, ARGHHHHHH - why didn't the test on Wednesday not pick up p24. Ok, nothing else really to say, only another two weeks and i'll find out. Thanks for your advice.

You say you're "never ill", but you've probably never been as stressed and anxious as you have been in the past two months or so either. Prolonged stress like that can really run you down and make you easy prey for any passing bug.

By all means call the GUM tomorrow and discuss this with them, but I think you're actually making yourself ill with all the anxiety you're going through right now. The phrases "you're going to make yourself sick" and "I'm worried sick" came about for a reason.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Thanks Ann - understand exactly what you say about the anxiety - I'm dealing with the anxiety and depression caused by this - I'm seeing a clinical psyhologist who has been involved in HIV since 1985 and working on techniques to deal with all of this

But, and I'm aware at this stage that i'm at risk of abusing these boards until I get further testing, I do have a specific question about what i'm going through - IF I am experiencing seroconversion (I know there is no way to know that till i've tested positive at the end of this) - how long does this process generally last for? I'm sick of feeling ill, my lymph nodes are so swollen in my neck, I'm having chills and my skin on stomach/chest is red (possible ars rash). Is there anything I can do to resolve the symptoms or do I just have to let my body do what it needs to do?

edited to add that I realise many people experience much worse during seroconversion, and I'm grateful that mine isn't as bad as some suffer

Well it's been 2 weeks almost, so hoping it goes away soon, the HIV clinic (they are dealing with me direct because of the PEP) got me in today because of the slight rash, and did another test (they said it's the guidelines if someone is displaying possible seroconversion symptoms after a high risk to do another test 7 days after the first) - so I'll find out tomorrow what that says Not hopeful but nothing I can do now.

4th gen Test done on 06/04 - also negative. Not sure what is going on, they said if I was seroconverting they would have expected either the anitgen or antibody to show up. And this is 4 and a half weeks after stopping pep - I have no idea why my lymph nodes are still swollen, or why my skin is so red, but at the moment I'm going to be hopeful and believe I have been lucky with this incident - No more testing till the required 6 and 12 week post pep time limits. Thanks for your help.

4th gen Test done on 06/04 - also negative. Not sure what is going on, they said if I was seroconverting they would have expected either the anitgen or antibody to show up. And this is 4 and a half weeks after stopping pep - I have no idea why my lymph nodes are still swollen, or why my skin is so red, but at the moment I'm going to be hopeful and believe I have been lucky with this incident - No more testing till the required 6 and 12 week post pep time limits. Thanks for your help.

Are you constantly checking your nodes? Poking at them will make them swell.

Leave them alone.

A negative test at 4 weeks bodes well for you. Really if you were going to seroconvert it's likely you'd have tested positive by now.

I totally agree with your GUM clinic. If what you're experiencing was ARS, the p24 antigen would have shown up, or the antibody portion of the test would have at least come back as - oh shit, the word escapes me right now - I want to say "inconclusive" but that's not right. It's when the result is partially reactive and there's a specific word they use. Damn my brain sometimes!

Anyway, you got a negative result and that is fantastic news. I fully expect you to continue to test negative. Keep us posted. Try to stay busy with other things while you wait for your conclusive results and as Matty so wisely says, keep your hands off your lymph nodes!

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I'm not touching those pesky nodes, whatever's going on I know me poking at them isn't going to help.

I get tested again on Monday, 6 weeks post pep- I always thought that would be the point that I'd really know whats happened. One mistake, that's all it takes.. I think i'll be very lucky to come out of this negative, my PEP nurse says it's the other way round, that i'll be unlucky to come away from this positive. I've got to focus on the negative results so far, which is obviously good news.

Still more symptoms... lymph nodes still enlarged, rash, yesterday i started getting tingling/numbness in back of left leg that's still there (please not shingles!?) - its either a horrible coincidence, anxiety induced, or a long drawn out (and mild thankfully) seroconversion. BUT as you've told hundreds before me - you are not here to hand hold, and I'm not the first or last person to have made a mistake and regretted it afterwards.

I'll update you on what happens on Monday - Im expecting the worst but the worst happens every day and people cope - so I hope I can be strong enough to deal with it

Tested negative. Six weeks post PEP. I think I have been very, very lucky. I still have to confirm at 12 weeks post PEP but the health advisor said this was more about following guidelines rather than an actual expectation that these results will change. Whatever is going on in my body, it must be a mixture of anxiety and coincidence. I'll update you all on the 30th may - Thank you so much for all your help during this time.

Went to my GP today for the lymph nodes, halfway through exam he asks if i've had unsafe sex recently!! Cue breakdown from me - had to tell him the lot, anyway I'm to go back to him in a fortnight if it doesn't get better. I'm not doing anymore testing till my 12 week one now.

I've started getting pins and needles in my feet for the past week, I've read that PN is very rare in seroconversion - if this is PN, combined with still swollen lymph nodes in neck - is it worth testing again before the 3 months are up? If it is PN then can they do anything about it or will I just have to live with it?

You've already tested negative at six weeks post-PEP. No, you don't need to test again until it's time for you to get your three month post-PEP confirmation.

It's doubtful you are experiencing true PN. As wound up as you are about all this, it's more likely to be due to all the anxiety you're going through. If you're worried about it, talk to a doctor. With that six week negative it is highly unlikely to have anything to do with hiv as you are highly unlikely to be hiv positive.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I'm going to see my GP tomorrow about the tingling/pins and needles - in both feet and hands now - random, don't think it's anxiety driven as I'm actually quite calm at moment, though I have been through a fair bit of stress these past few months! Anyway, I'm obviously hoping that it's not related to some random seroconversion - also google can be a bit of a nightmare, I'd diagnosed myself with hiv related Guillain-Barre syndrome last night! - i'm hoping that's not the case, no muscle weakness just tingling/pins and needles, but I'm going to let the GP do the diagnosing on this one.

On one hand - PEP has a good success rate and I've tested negative at 6 weeks post PEP on a 4th generation test.

So when I start thinking i've been lucky, my lymph nodes still haven't gone down, and over a week I've developed what I think could be PN (but i'll get that checked tomorrow at GP). I need to keep telling myself it's rare for pep to fail, apparently it's very rare for PN to occur so early, and it's rare for a 6 week test to change.

You need to step away from your computer and leave google the hell alone. Stop misdiagnosing yourself. Even doctors go to other doctors when they feel unwell, they don't self-diagnose. Knock it off already.

There are tons of different things that can cause PN - including but not limited to being deficient in certain B vitamins. And yes, it would be rare in the extreme for hiv to cause PN this early. I've only heard of one person who had PN associated with seroconversion, but he was so ill with high fevers that he had to be hospitalised. You have not been that ill.

With that six week negative in hand, it's pretty much a dead cert that you're going to continue to test negative. So get off the internet and go do something productive. It's spring - do some spring cleaning. And leave your lymph nodes alone. You're not helping matters by checking them all the time. Knock it off.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Thanks for your advice Ann, I needed that virtual slap, and I took your advice and cleaned my car

I went to my GP regarding the pins and needles, turns out i've developed a deficiency in B12 (as you pointed out I could have). My diet is good so the GP was a bit stumped as to what might cause it and is getting back to me next week. Anyway, i'm not going down the line of googling HIV and anemia, as I know where that will take me, and I will only get that answer 4 weeks down the line.